Training effects on speech production using a hands-free electromyographically controlled electrolarynx.

PURPOSE The electrolarynx (EL) is a widely used device for alaryngeal speech, but it requires manual operation and produces voice that typically has a constant fundamental frequency. An electromyographically controlled EL (EMG-EL) was designed and implemented to provide hands-free control with dynamic pitch modulation. METHOD Three participants who underwent total laryngectomy surgery and 4 participants with normal voice were trained to produce EMG-EL speech through a multiple-baseline, successive-stage protocol. Baseline performance was established through 3 testing probes, followed by multiple hour-long training sessions. RESULTS At the end of the training, all participants learned to initiate, sustain, and terminate EMG-EL activation in correspondence with articulation, and most were able to modulate the pitch to produce intonational contrasts. After completing the testing/training protocol, 1 of the 3 participants who underwent total laryngectomy was encouraged to independently use the EMG-EL at his residence. This participant sustained his performance for an additional 6 weeks and also used the EMG-EL successfully to communicate over the phone. CONCLUSIONS Our findings suggest that some participants with laryngectomies and vocally normal individuals can learn to produce hands-free speech using the EMG-EL device within a few hours and that significant additional gains in device control (particularly pitch modulation) are attainable through subsequent training sessions.